Online Employment Application

Date/Time

Position Desired: (required)

Availability (Please indicate all that apply:)

Date Available: MM/DD/YYYY (required)

Overtime Restrictions?

Yes

Availability (required)

Full Time

Part Time

Application Information

First Name (required)

Last Name (required)

Address Line 1 (required)

Address Line 2

City, State, Zip (required)

Home Phone:

Cell Phone:

Work Phone:

Message Only Phone:

Email: (required)

Criminal Convictions/Traffic Violations: Have you been convicted of:

Misdemeanor

Felony (excluding juvenile adjudication)

A moving traffic violation with the last five years?

Criminal/Traffic Violations Statement Upload

Do you have any relatives working for Rio Rico Fire District? (required)

Yes

If yes, state name(s) of relative(s) and relationship(s):

Please give us specific information regarding your answer above (name(s) of entity, website, persons) (required)

Have you ever applied with RRMFD before? (required)

Yes

Position(s) applied for:

Date you applied: (MM/DD/YYYY)

Employment History

Lack of Requested Information is Basis for Rejecting an Application. To avoid rejection please answer all items completely. Account for all time in the past 10 years whether working or not. Start with your most recent experience and work backward. Include military service and any period of unemployment. Do not say (see resume). If you are currently employed, we will contact your employer prior to employment.

Current or Most Recent Employer (required)

Employer's Address (Address Line 1) (required)

Address Line 2

City, State, Zip (required)

Employer's Phone (required)

Employer's FAX

Start Date (MM/DD/YYYY) (required)

Date of separation (if applicable) MM/DD/YYYY

Supervisor's First Name

Supervisor's Last Name

Duties: (required)

Reason for leaving: (required)

This application is only valid for open, advertised positions. Rio Rico Medical and Fire District is not obligated to retain or consider this application for future openings.

Upload Resume/Academy Essay

Employer's Name:

Employer's Address (Address Line 1)

Address Line 2

City, State, Zip

Employer's Phone

Employer's FAX

Email (required)

Start Date (MM/DD/YYYY)

Separation Date (MM/DD/YYYY)

Supervisor's First Name

Supervisor's Last Name

Duties:

Reason for leaving:

Please use the same format as above and upload additional employer information (PDF or DOC File) to satisfy the past 10 years requirement if necessary.

Additional Employer Information Upload

Education and Training:

High School: (If you attended more than one please provide the most recent and include the additional schools in a separate document which can be uploaded below.)

High School Address Line 1

Address Line 2

City, State, Zip

Obtained:

Diploma

GED

Upload Resume/Documents

Date received: (MM/DD/YYYY)

Upload Diploma, GED and/or additional school information

College or University (If you attended more than one please provide the most recent and include the additional schools in a separate document which can be uploaded below)

College or University Address Line 1

Address Line 2

City, State, Zip

Major Fields of Study

Upload Degree(s) and/or additional school information

Professional Skills and/or Training (Please mark all that apply:)

Describe any special training, courses, or certification relating to the position you are seeking:

Upload Certifications, Professional Licenses, Training records

Upload Documents(Resume, Academy Essay, Misc. Docs) (required)

Languages spoken:

Please read carefully and check the box next to each statement before submitting your online application:

Acknowledgment (required)

I certify that the information given by me in this online application is true and complete.

I understand and agree that the application process or my employment with Rio Rico Medical and Fire District many be immediately discontinued if misrepresentations, falsified statement, or material omissions are found to have been made.

I authorize investigatory agencies, schools, former employers and former supervisors to provide any and all information pertinent to my employability, and hereby release those providing such information from any liability for doing so.

I understand that employment, if offered, is contingent upon satisfactory results of a drug screening, employment verification, criminal background check utilizing fingerprint analysis, motor vehicle report, **Physical Examination** and written tests as required by the District. I also understand that employment , if offered, is contingent upon my providing additional information for employee record purposes and upon my providing proof of identity and lawful authorization to work in the United States and completing a for I-9. (**if applicable).

I have read the above, understand its content, and meaning, and agree to all of its provisions. I understand that upon my request, I will be provided a copy of my executed employment application.

By submitting this form I agree that I, have read, understand, and agree with the above listed conditions. (Please electronically type your signature here) (required)

Date/Time

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